The University of lowa submits this renewal application for continued participation in the NICHD Cooperative Multicenter Neonatal Research Network (RFA-HD-10-003). We offer five special strengths to the Network. 1. Our NICU's clinical outcomes are superb - among the best in the world. Our VLBW mortality is perennially the lowest in the Neonatal Research Network. With our low mortality and high follow-up rate, we see as many as VLBW infants in follow-up as some much larger Network centers. 2. We have a strong tradition and track record of important contributions in clinical research in neonates and infants. In the obstetrics units and the NICU, we have a robust infrastructure for the conduct and support of clinical research that has contributed to our productivity. 3. We have considerable expertise and resources in the area of genetics, including our Perinatal Research DNA Bank, which was created in 1999. Samples from our DNA Bank and others are being used for research on the genetic influences of neonatal disease. During our first 5 years in the Network, one of our investigators, Dr. Jeff Murray, has worked with others in the Network to apply genetics and genomics approaches on a Network-wide scale, including the application to develop a prospective DNA repository. 4. As the only academic medical center in a largely rural state with an economy based in agriculture, we represent a population that is not otherwise well represented in the NICHD Network. If the results of Network studies are to be generalized to patients throughout the country, this large area of the country should be represented. The University of lowa Network center represents this region and population. 5. We have performed extremely well as a Network center during the past 5 years. We have contributed approximately 1/6 of the new projects submitted in the current funding cycle. Our ELBW mortality rates are the lowest in the Network, and we have the lowest rate of the composite outcome of death or neurodevelopmental impairment. Our follow-up rate is among the highest in the Network. Our patient enrollment in the Generic Database has more than doubled since we added a second site early this year.